Does intermittent "pulse" topical 5-fluorouracil therapy allow destruction of actinic keratoses without significant inflammation?
Does intermittent "pulse" topical 5-fluorouracil therapy allow destruction of actinic keratoses without significant inflammation?
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DOI：
10.1016/s0190-9622(98)70542-0
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发表时间：
1998-01-01
影响因子：
13.8
通讯作者：
Epstein, E
中科院分区：
文献类型：
--
作者：
Epstein, E
背景：外用5-氟尿嘧啶（5-FU）可有效去除光化性角化病，但会引起不美观和疼痛的糜烂。间歇性“脉冲”5-FU治疗已被描述为一种有效和舒适的技术，用于破坏光化性角化病。目的：本研究的目的是确定间歇性5-FU治疗的疗效和皮肤副作用。方法：由三名经验丰富的皮肤科医生分别比较随机安排的治疗前后照片，评价治疗效果。根据治疗期间拍摄的照片对皮肤反应程度进行分级。结果：13例患者接受间歇5-FU治疗，2例效果良好，3例效果良好，8例无明显改善。效果与皮肤受刺激的程度有关。结论：脉冲5-FU对大多数患者光化性角化病的清除效果不明显。间歇性5-FU治疗不能将其治疗效果与其不良的侵蚀作用分离开来。脉冲疗法是采用5-FU的一种强度较低的方法，对于那些不愿接受每日5-FU应用的传统疗程所带来的腐蚀和不适的患者可能有价值。
Background: Topical 5-fluorouracil (5-FU) is effective in removing actinic keratoses but causes unsightly and painful erosions. Intermittent "pulse" 5-FU therapy has been described as being an effective and comfortable technique for destroying actinic keratoses.Objective: The purpose of this study was to determine the efficacy and cutaneous side effects of intermittent 5-FU therapy.Methods: Efficacy of treatment was evaluated by three experienced dermatologists separately comparing randomly arranged before and after photographs. Degree of skin reaction was graded from photographs taken during treatment.Results: Of 13 patients treated with intermittent 5-FU, two had an excellent result, three a good result, but eight failed to show discernible improvement. Efficacy was linked to the degree of skin irritation.Conclusion: Pulse 5-FU failed to clear actinic keratoses in most patients. Intermittent 5-FU treatment does not dissociate its therapeutic efficacy from its undesirable erosive effects. Pulse therapy is a less intensive way of employing 5-FU and may be of value in patients unwilling to accept the erosions and discomfort that accompany the traditional course of daily 5-FU applications.